A comparison of oxycodone prolonged‐release vs. oxycodone + naloxone prolonged‐release after laparoscopic hysterectomy

Abstract

Addition of naloxone to oxycodone PR tablets in a pain regimen administered twice daily the first three post-operative days had no significant clinical effects on constipation or other variables during the first week after hysterectomy.

Oral immediate and prolonged release oxycodone for safe and effective patient controlled analgesia after surgery Can opioid for acute postoperative pain be improved by adding a peripheral opioid antagonist?

“…The study by Comelon and co-workers [13] on bowel functions after laparoscopic hysterectomies did not find effects on postoperative bowel function when comparing OxyContin ® 10 mg without naloxone with OxyContin ® 10 mg with 5 mg naloxone added (= Targin ® , Targiniq ® , Targinact ® ) twice daily. The amount of rescue oxycodone needed was considerable, thus it appears that the dose of prolonged release oxycodone was too low for pain relief [13]. In addition, it follows that the 10 mg of naloxone daily was too low to antagonize the bowel dysfunction caused by the total dose of oxycodone given after that operation.…”

“…Moreover, for acute opioid-induced constipation in opioid naive patients a larger dose of a peripherally acting opioid antagonist is needed, compared with in patients on long-term opioid treatment for chronic pain conditions [10]. It is reasonable to expect the same is true for the prolonged release naloxone in the Targin ® , and that the dose of 10 mg of naloxone, also for this reason, was too small in their study [13].…”

“…However, two studies documented significant improvement in postoperative bowel functions, one also improved the passing of urine, an often neglected adverse effect of postoperative pain treatment with opioids [11][12][13]. The study by Comelon and co-workers [13] on bowel functions after laparoscopic hysterectomies did not find effects on postoperative bowel function when comparing OxyContin ® 10 mg without naloxone with OxyContin ® 10 mg with 5 mg naloxone added (= Targin ® , Targiniq ® , Targinact ® ) twice daily. The amount of rescue oxycodone needed was considerable, thus it appears that the dose of prolonged release oxycodone was too low for pain relief [13].…”

Can early oral prolonged-release oxycodone with or without naloxone reduce the duration of epidural analgesia after cystectomy? A 3-arm, randomized, double-blind, placebo-controlled trial

“…However, they used oxycodone as a first line analgesic treatment, and no regional technique was used with the exception of bupivacaine injection at the incision sites. [12] An explanation why prolonged-release oxycodone failed to reduce the duration of TEA could be the specific pharmacokinetic conditions related to the early postoperative setting of a small bowel resection and anastomosis.…”

Oxycodone/Naloxone: Role in Chronic Pain Management, Opioid-Induced Constipation, and Abuse Deterrence

“…Three published studies have addressed use of OXN for postoperative pain following orthopedic, gynecological, and cardiac surgery, with mixed results [63, 71, 72]. Improvement in bowel function has not been unequivocally demonstrated, potentially complicated by the low doses and brief treatment courses used and impact of gastrointestinal surgery on bowel function; analgesia was similar to intravenous (IV) opioids [63, 71, 72]. OXN is not recommended before surgery or for 12 to 24 h in the immediate postoperative period [46].…”